代谢综合征患者腹内脂肪与心血管损害的关系

Relationship between visceral adipose and cardiovascular damage in the patients with metabolic syndrome

目的分析代谢综合征(MS)患者腹部脂肪分布及与心血管损害的关系。方法108例住院患者分为MS组(70例),高血压组(EH,22例),2型糖尿病组(T2DM,16例),计算三组腹内脂肪面积(VA)、腹壁脂肪面积(SA)及VA/SA,并分析它们与左室重量(LVM)、左室重量指数(LVMI)、颈动脉内膜中层厚度(IMT)、心肌缺血的关系。结果MS组患者较EH组和T2DM组VA显著增高(115·69±48·72cm2vs69·96±25·41cm2、55·96±29·75cm2,P均<0·01),VA≥80cm2组较VA<80cm2组LVM、LVMI均明显升高(186±70gvs155±44g,51±17g/m2vs44±13g/m2,P均<0·05),VA/SA≥0·75组较VA/SA<0·75组左、右侧IMT均明显增厚(0·90±0·41mmvs0·75±0·21mm,0·89±0·32mmvs0·77±0·21mm,P均<0·05),VA≥100cm2组心肌缺血率和缺血程度明显高于VA<100cm2组(P<0·05)。收缩压、舒张压、VA导致IMT增厚的OR值有显著意义。结论代谢综合征时腹内脂肪明显堆积,其堆积的程度与心血管损害的程度密切相关,且腹内脂肪是心血管损害的独立影响因素。

Objective To analyze the relationship between the distribution of visceral adipose and cardiovascular damage in the patients with metabolic syndrome. Methods 108 in-patients were categorized according to the diseases, they were suffering from into metabolic syndrome group （MS, 70 cases）, essential hypertension group （EH, 22 cases）, and type 2 diabetes mellitus group （T2DM, 16 cases）. The areas of both visceral adipose （VA） and subcutaneous adipose （SA） were measured for all the three groups, and then VA/SA was calculated. The relationship of the above variables with left ventricular mass （LVM）, LVM-index （LVMI） intima-medial thickness （IMT） of carotid artery, and myocardial ischemia was analysed. Results Compared with T2DM and EH groups, the area with VA was significantly larger in MS group （P〈0.01） ; LVM and LVMI were significantly higher in the patients with VA≥80cm^2 than that of those patients with VA〈80cm^2 （P〈0. 05） ;IMT was significantly thicker in the patients with VA/SA≥0. 75 than that of those patients with VA/SA〈0. 75 （P〈0.05） ; the incidence and severity of myocardial ischemia were significantly higher in the patients with VA≥100cm^2 than that of those patients with VA〈100cm^2 （P〈0.05）. Conclusions The area of VA in the patients with MS is obviously larger than that in the patients with T2DM or EHP;the severity of cardiovascular damage is closely correlated with the area of visceral adipose tissue.